The ‘new’ Act was supposed to restore confidence in aged care. Its first anniversary arrives with the government still trying to restore confidence in the way it has been implemented.
Most one-year-olds have learned the meaning of the word “no”. The new aged care system, which turns one tomorrow, is still working on that.
How many times since 1 November 2025 have the Department of Health, Disability and Ageing, aged care minister Sam Rae and federal health minister Mark Butler been told no?
At some point, surely, they will figure out that the steady stream of headshaking coming from older Australians, the providers, the clinicians, the researchers, and yes, the media, actually mean something.
And, perhaps, at some point in 2028, they will get the message if – many would argue when – aged care becomes an electoral issue for Labor.
Of course, there is a difference between aged care becoming an electoral vulnerability for Labor, and aged care actually determining votes at the next federal election.
The first is already a credible political question. The second is much harder to establish.
The irony is that Labor brought in the new Act promising a more rights-based, sustainable aged care system.
A year later the political conversation is still dominated by access to care, waiting times, assessment decisions and the concessions Mr Butler and Mr Rae have made in response to criticism.
The evidence – and a long-running straw poll taken by me whenever I’m in the company of other adults – suggests aged care has become a contested political issue, although we don’t yet have hard data on whether it’s changing voting intentions.
Goodbye parliamentary consensus
Labor has somehow managed to lose the parliamentary consensus around parts of its reform, despite the overwhelmingly bipartisan responses to the Royal Commission, of blessed memory.
On 2 July this year, the Senate passed legislation to restore human discretion in aged-care assessments, with the Coalition, Greens and crossbench support. That’s a significant change from the broad parliamentary support surrounding the new Act itself.
And while you could argue that the bill to cut the private health insurance rebate for over 65s in order to provide $3 billion more for aged care was a worthy goal, the method has, again, united Coalition, Greens and crossbenchers alike against the government. Senate says no, again.
Beyond the DoHDA’s control
The controversy has moved beyond the sector and therefore, out of the government’s control.
Apart from the small but mighty efforts this publication has been making since December of last year, the ABC’s Four Corners investigation in August brought individual experiences of the Support at Home program’s integrated assessment tool to a national audience.
We all know that Labor backbenchers have been hearing complaints from their constituents and have raised concerns with Sam Rae.
That’s an important political indicator: the issue was reaching MPs through their electorates, not simply through industry lobbyists, and we, poor, weary media hacks.
Turning on itself
The government is now defending the system against the Commonwealth’s own watchdogs.
The Commonwealth Ombudsman’s October report identified serious problems with transparency, fairness and human oversight.
An independent review has been commissioned, but unless the Department pulls its usual sneaky Friday Night News Dump or does some work on a Saturday, its findings won’t be available before the Act’s first anniversary.
The government’s own Inspector-General of Aged Care, the now sadly departed Natalie Siegel-Brown was staunch in her criticisms of what she felt was a noble intent that has gone horribly wrong in the implementation.
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The public totally gets it
There is a readily understandable household issue beneath the policy complexity.
Waiting for an assessment, receiving an inadequate funding classification, or struggling to secure care at home can affect older people AND their adult children.
The political reach of aged care therefore isn’t necessarily confined to pensioners. That’s a plausible mechanism for electoral salience, rather than evidence of voting behaviour.
I’m in the sandwich generation. I have an 88-year-old mother in care, and I’m about to turn 62 – if Mr Butler, Mr Rae and the Department don’t think me and my cohort are thinking about this from all angles, they are sadly mistaken.
And we vote. Boy, do we vote.
The good news for Labor
As ever, the best thing going for the Labor government is the lack of quality on the other side of the Parliament.
Senator Anne Ruston is a hard-working, smart, dedicated operator, who deserves to be health and/or aged care minister one day. Streets ahead of her colleagues.
But, as I’ve said before, as long as she’s outranked and surrounded by hard right, gumby-headed white fellas, her chances are slim, even if the Coalition does get elected.
The other good news?
Labor can point to genuine reforms, including new rights and quality standards, the removal of some personal-care contributions, additional packages and the retention of Commonwealth Home Support Program.
The department is also evaluating the assessment process and Support at Home, with consultations underway this month.
But let’s call a spade a shovel. Most of those things wouldn’t have needed to be walked back if they hadn’t been introduced – against expert advice – into the new Act in the first place.
No, no, no … and no
The obstinance, arrogance and plain, downright hard-headed stubbornness surrounding the government’s attitude to the integrated assessment tool will go down in the annals of aged care.
It’s unbelievable the knots Mr Butler, Mr Rae, department secretary Blair Comley, and aged care group boss Sonja Stewart tie themselves in to profess confidence in a tool that has such potential for harm, delay and injustice.
Oh, we can’t let there be human over-ride because that would be against the rules. Blah, blah, blah.
Who wrote the damn rules in the first place?
Come on.
But it’s just a baby
The bleating in senate estimates this week was laughable. Mr Comley and Ms Stewart were outraged at the criticism.
“It’s not even a year old,” they whined. How dare we expect it to be perfect.
The Act was supposed to restore confidence in aged care. Its first anniversary arrives with the government still trying to restore confidence in the way it has been implemented.
And every one of the problems was created by the Department itself in the drafting of the Bill. Every. Single. One.
What’s needed is a little self-awareness, humility and genuine intent to do the right thing by our elders no matter how many mistakes the Department and the politicians have to correct.
Wouldn’t it be good to be able to say, on the eve of the Act’s second birthday, that things are actually better for older Australians as a result of the reforms?
I’m not holding my breath, but I am holding a little hope.